Let's Be Reasonable

AUTHOR(S)

McBride, Scott

PUB. DATE

October 2002

SOURCE

Venulex Legal Summaries;2002 Q4, p1

SOURCE TYPE

Law

DOC. TYPE

Article

ABSTRACT

The article reports on the publication of an interim rule by the U.S. Centers for Medicare & Medicaid Services (CMS) on December 13, 2002, regarding the inherent reasonableness adjustments process for all Medicare Part B services. Exempted from this rule are services paid under the Medicare physician fee schedule or prospective payment system. The new rule allows CMS more flexibility to make adjustments to payment rates and to ensure that the rates are reasonable and equitable.

ACCESSION #

23541346

Related Articles

The article reports on the revamp of the inpatient prospective payment system (IPPS), released by the Centers for Medicare and Medicaid Services (CMS) on August 1, 2007. CMS stated that the restructured diagnostic-related groups (DRG) will account more fully for the severity of each patient's...

Focuses on the effect of the rehabilitation rule proposed by the U.S. Centers for Medicare & Medicaid Services on inpatient rehabilitation hospitals and units in 2003. Deadline for comments on the proposed rule; Efforts taken to modernize the rule; Proposal of Senators Ben Nelson (D-Ne.) and...

The article reports on the U.S. Centers for Medicare and Medicaid Services' (CMS) newly proposed rules for gain-sharing and other pay-for-performance initiatives. The proposed rules are part of 2009 physician-payment policies that the CMS is seeking comment on from healthcare providers and...

The article discusses the 2% reduction in annual Medicare fee schedule for hospital facilities that did not participate or failed the submission requirements for health care quality initiative in the U.S. in 2007. The Centers for Medicare & Medicaid Services (CMS) reported that 28 of the 3,490...

The article reports that the U.S. Centers for Medicare & Medicaid Services (CMS) is planning to raise Medicare payment rates for financial year 2011 for skilled nursing facilities by 1.7 percent. CMS is also proposing changes to the Medicare home health payments for 2011. The proposal calls for...

The article comments on the role of the Center for Medicare and Medicaid Innovation (CMI) in facilitating beneficial changes in the health delivery system in the U.S. According to the authors, the CMI would examine innovative payment and service-delivery models designed to minimize Medicare and...

The article reports on the modification of the memo for Centers for Medicare and Medicaid Services (CMS) in the U.S. The memo was issued on June 8, 2007 and updated the information for the implementation of the 75 percent rule of inpatient rehabilitation facility (IRF) prospective payment system...

The article focuses on Medicaid Integrity Program (MIP) launched by the U.S. Centers for Medicare and Medicaid Services (CMS). It informs that the program is aimed to prevent Medicaid fraud and abuse and it will come into effect from end of 2008 or early 2009. It mentions that CMS is contracting...

The article focuses on recovery audit contractor (RAC) program related to healthcare payments in the U.S. It informs that the U.S. government hopes to recover about $3 billion in overpayments to healthcare providers, when the RAC program comes into effect in 2010. The Centers for Medicare and...